Provider Demographics
NPI:1710632047
Name:LAUSH, ROXANNE MARIE (NBC-HWC)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:MARIE
Last Name:LAUSH
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 N DELPHINE ST
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-2345
Mailing Address - Country:US
Mailing Address - Phone:206-669-8459
Mailing Address - Fax:
Practice Address - Street 1:1309 N DELPHINE ST
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-2345
Practice Address - Country:US
Practice Address - Phone:206-669-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date: